Pregnancy and you blog

Blog: Gestational diabetes — some explanations

I'm looking forward to becoming a grandmother for the first time, likely in January. My daughter isn't always enjoying her pregnancy, but she's deeply in love with her baby. Last week, she was scheduled for her gestational diabetes test — often referred to as a glucose challenge test. She had read about it but still had some questions. I thought this would be a good place to answer them since you may have similar questions.

During pregnancy, the placenta produces hormones that interfere with insulin. If insulin can't get into your cells, your blood sugar level will rise. If your body isn't able to produce enough insulin to control your blood sugar level, you may develop gestational diabetes.

Some health care providers screen all pregnant women for gestational diabetes. Others screen only women who have specific risk factors — such as being older than age 25, being overweight, having a personal or family history of diabetes, having given birth to a baby weighing more than 9 pounds (4 kilograms), or being a member of certain ethnic groups.

The glucose challenge test is usually done between weeks 24 and 28 of pregnancy. The test itself isn't too bad. You'll begin by drinking a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. If your blood sugar level is higher than normal, you may need a different type of follow-up glucose challenge test.

If you're diagnosed with gestational diabetes, diet and exercise become especially important. You'll get a glucose meter and learn how to check your blood sugar level, and your health care provider might recommend consulting a registered dietitian for help developing a meal plan. If diet and exercise aren't enough, you may need oral medication or insulin shots.

The possible complications of gestational diabetes — such as preeclampsia and a risk of developing diabetes later in life for mom and excess growth, low blood sugar and breathing trouble for baby — are scary. Still, making healthy lifestyle choices can go a long way toward ensuring a healthy pregnancy.

If you've been diagnosed with gestational diabetes, how have you been handling the condition? Please share your stories.

Just a few days ago I received the call that told me I had gestational diabetes. I think I spent the day crying. Now, I am lost. I do not know what to eat, what to not eat. The nutrition class isn't until April and I am at a complete loss. This confirms my extreme fatigue, thirst and increased appetite but also the dizziness and feeling like I am faint.

Veronica W.

November 7, 2013 12:09 p.m.

I am almost 13 weeks, 5'8 and 150 (no weight gain yet). My fasting glucose test was high (106) and with some food and exercise changes I've brought it down to 90 in the last week. All of my other levels are normal throughout the day. My doctor is already talking about meds, but I feel like the changes I'm making are working - any guidelines on how much longer should I try making food and exercise adjustments before going ahead with meds?

liz

January 31, 2013 8:37 p.m.

If you have gestational diabetes and develop diabetes are you and your family at the same rsk of others who have type 2?

Jo

January 4, 2013 11:41 a.m.

San Jose Mom, you are doing all of the right things. I can understand your suprise with the diagnosis. You don't follow the risk factors for GD. It sounds like you are doing all of the right things. If you do have to start on medication, it will be safe for your baby. When you ask about future effects, there is some research but it is hard to seperate the medication and the GD in terms of long-term effects. I recommend you work closely with a dietician or nutritionist. If you can work with someone to individualize your workout to get the maximum effect you may be more successful keeping your blood sugars in the range that has been set for you. Let us know how you are doing with this.

Mary@Mayo

December 31, 2012 7:49 p.m.

I have just been told I have GD. I am 5'2&quot; &amp; 120 lbs previously, now 27 weeks with my first baby and have gained 19 lbs so far. I never thought that I would be diagnosed with GD. Anyways, I have to start managing my diet and exercise routine (which I have been putting off due to the weather and a recent cold).
If I have to start using any medications in addition to the diet and exercise, are there any side effects of these drugs on the baby itself (now/future)?

San Jose Mom

September 30, 2012 4:07 a.m.

Karen, it sounds like you have a pretty good handle on the gestational diabetes. If you are not comfortable with the providers plan, ask questions until you are comfortable or seek another opinion.

Mary@Mayo

September 26, 2012 8:18 a.m.

Im 32 weeks n 4weeks ago i was told i had gestational diabetes my reading are always good in the morning n lunch but for dinner is a lil high is 130 the highest but the dc wants me 2do insulin shots b4 breakfast n dinner n also do a long lasting insulin shot b4 i go to sleep i just think is a lil excessive im on bed rest so i can't really exercise, should i get a 2nd opinion?

Karen

June 28, 2012 2:28 a.m.

Gestational diabetes can be tested for early in pregnancy, during the middle of pregnancy and at 24-28 weeks. Some clinics test at the first visit. When you are tested or if you are tested may be decided by risk factors. Getting into the habit of regular exercise before pregnancy or in early pregnacy can help.
If you are diagnosed with gestational diabetes, it may take a couple weeks to find out what diet changes will help keep the blood sugars where you want them.

Mary@Mayo

June 22, 2012 6:33 a.m.

In which week of pregnancy the chances of gestational diabetes are increased. I am now 16 weeks pregnant and worry about such complications.

zoii

May 19, 2012 5:53 p.m.

I'm 38 yrs old and 32 weeks with twins and failed glucose challenge test with a result of 279! No need to even do the 3 hr test, thankfully. Emotionally, very upsetting and i cried everyday for the first week. Had really felt i failed our babies somehow. A change in diet did nothing to move blood sugar levels so was put on insulin (rapid acting before each meal and long term dose at night before bed). It took a couple weeks to balance right dosages with food intake (all of which is being supervised by endocrinologist and diabetes educator/nutritinist). But now sugar levels are all almost in range! Have also been walking in pool every other day.
My best advice is be diligent with monitoring blood sugar and keep food journal. Then you can see what food might be triggering spikes. Until you've got good control over numbers don't drink any fruit juices - add it back in in small quantities to see affect on sugar level. Unfortunately for me I cannot have fruit juice or milk bc they make my results skyrocket. Most importantly, once you reduce carb intake and safely increase exercise, don't get frustrated if your numbers aren't moving. It's not your fault and you may be very resistant to insulin which may require insulin. It's better to do whatever necessary to improve results to eliminate complications at birth and shortly thereafter.
Stay positive! Do your part! And let modern medicine offer additional help if need be. Good luck!!

Ventura County Mom

April 17, 2012 3:14 p.m.

I am 34 weeks pregnant and was diagnosed with gestational diabetes about a month ago. Since then I have radically changed my diet -- cutting out all sweets, sodas and trying to maintain a specific number of carbs at every meal. I have been told to see an endocrinologist -- and despite having healthy AC1 levels, NOT having keytones in my urine (an indicator that you are not eating enough carbs -- which is VERY unhealthy for baby), and mostly decent blood levels (fasting is always low -- 80 at the highest -- but I recently have had much work stress and maybe 3-4 post-meal spikes in the 160's), AND the OBGYN says I am having a normal sized baby ... despite all of this they want to put me on insulin.
I don't understand why and feel like this is excessive. As I test what will and what will not spike my glucose levels, am I not allowed to have some bad readings? Also I tested my meter versus the one in the office today -- and my reading was 25 points higher than hers.
I just don't understand. Is this really necessary? Should I get a second opinion?

Stephanie

April 6, 2012 8:15 p.m.

I am pregnant with my 3rd child. With each of my pregnancies I have been GD. The first baby I didn't find out until my 4-5 month, and gained 46 pounds. The second baby, I found out in the 4th month and this one I was tested about my 10th week. I knew going in that I would have it with this baby as well. I was insulin dependent with the first 2 for the whole pregnancy, and this time I have been taking glyburide for 6 weeks. I have just been told to increase my dosage in the mornings, due to my high numbers for after lunch and dinner. My fasting glucose on the meds have been the best numbers, all except one here and there close to the cut off of 105. In all my pregnancies I did the 1 hour gtt and the next week I would go in for the 3 hour gtt. I failed all but one number for the 3 hour test. I have been healthy and exercised up to 5 times a week. It doesn't matter what you have done prior to pregancy. It isn't anyone's fault it is what it is. I see my Ob doctor, a dietician and a neonatalogist monthly for checkups due to my diabetes. Both my boys are healthy today. One is 13 and the other is 8. My fist son's water broke prematurely at 36 weeks, and I was hospitalized and on bed rest for 10 days before they induced me, due to his heart rate falling to around 120. He was born a month prematurely. He did have some problems with learning to speak, learning to walk, and being diagnosed with ADHD. My youngest has no problems and is doing well in school.

Mary

February 12, 2012 8:25 p.m.

With my first child I couldn't control my gestational diabetes with the diet they had me on and tell everyone else to eat. I am now 27 weeks with my 2nd girl on the way and once again failed the 1hr glucose test. I went back for the 3hr test and 1 was elevated the other 2 were borderline. A friend told me about Dr Richard k Bernstein and the paleo style diet. It is a low carb high fat (the good fats) my bloodsugars have been 90-113 average and I've never eaten so much and been felt better while pregnant! I do best at about 20 g of carbs a meal but still experimenting on what I can and cant eat and still eat right for 2. My suggestion if you're concerned or borderline get a meter and test test test. The highs and lows of eating the way they tell you and having to use insulin is very taxing on you and your baby's beta cells and can cause long term damage which is why you hear of people who have GD are at a higher risk for type 2 later in life. Enjoy hope all goes well for everyone.

lacey

January 9, 2012 4:07 a.m.

This blog is really a great source of information which is very useful for me. Thank you very much for such important information.
FOR BEST INFORMATION ON DIABETES.

jOHN

September 11, 2011 10:15 p.m.

I completely understand about how knowing you were healthy and being active and at a normal weight can completely throw you off when they say you have gestational diabetes. I was told three weeks ago, (26 weeks) that I have it, and I have no risk factors either. I was a mess that entire week. After reading many credible sites and asking a lot of questions between my diabetes educator and dietician, I feel more at peace that it was not my fault, there was nothing I could have done to prevent it and that most likely it will go away once they cut the cord. The more questions I ask the better I feel. However, the diet was not enough and now I'm on a low dose of insulin to compensate for my insulin resistance. (let me tell you that it hasn't been great sticking a small needle into my skin for every meal, but knowing it's helping the little one, totally gets me through.) Anyways, the diabetes educator let me know that the risk of type 2 is a lot more likely since I have gd, so this has been a big wake up call as far as my normal diet goes. I know that I will probably be forever concious of the carbs and sugars I take in, and the exercise that I get, so that I can avoid Type 2 for as long as I possibly can, if not skip out on it completely.
I'm really excited to see our little one, and I know that the journey will be worth it in the end. Don't get to hung up on the why, just find things you can eat and keep it in portions!

Laurie

June 29, 2011 12:07 p.m.

Hello,
Went in for my glucose screening test and wasn't told what foods to avoid beforehand, so I had Special K cereal with protein, 1% milk, cranberry juice (bladder infection), and an Activia vanilla yogurt all around 5:30a.m. My appt was at 9:30 a.m. and I had celery with peanut butter as a snack on my way to the appt. They tested me anyways and my blood sugar was at 204 after the glucola so they diagnosed me with gest. diabetes on the spot. Have also had pre-term labor symptoms the past two weeks so am now on bed rest for the time being. I am a healthy, active pregnant female, gained about 22 lbs at 30 weeks pregnant and was working out until I was placed on rest. I guess I feel very overwhelmed by this diagnosis as I don't feel that I fall into the risk category and am having a very difficult time accepting it...broke down when I had to schedule my nutritional assessment meeting with a dietician. It's all out of pride/vanity, I realize this and will do WHATEVER it takes to keep my baby healthy but just needed to vent a little...it's hard not having control over this when I feel that I have done everything I can to remain healthy for our baby:(. Sincerely, Autumn

Autumn

May 14, 2011 11:42 p.m.

Type 2 diabetes onset during pregnancy? I am 35 yrs old, was told at 10 weeks pregnant, as a result of fasting glucose blood test that I am type 2 (not gestational) and will be the rest of my life (number was 202). 9 weeks earlier, AC1 and glucose tests were normal. They claim I must have had it before pregnancy, but I have proof of normal numbers. Is this true, will I have it forever now? Does not make sense to me.

danielle

March 3, 2011 10:55 p.m.

I was just informed I have GD by my OB's nurse.Need less to say I was really upset , Im I asking to much to think the doctors would have spoking to me themselves. My family has a history of diabetes , I had just lost 43 lbs before I found out I was pregnant. It through me for a loop , never had it with my three previous pregnancies. I just want to learn how to deal with GD the rightway and jungle work , home and family life !!! Im worried for my baby , just want to handle this all the rightway .

Lorry

January 9, 2011 2:01 a.m.

Many of you are nervous about the effects GD will have on you and your baby and confused about the numbers you are seeing when you test. My advice (I have had GD for 2 out of 3 pregnancies; no family hist of diabetes, and I'm 5'6 132lbs) is to talk to your Dr and/or a nutritionist. From what I know, a fasting number above 100 is borderline to too high and may indicate actual diabetes (esp. in early preg). Log what you are eating as some foods may cause your numbers to be higher (I can't eat any cereal, oatmeal, or baked potato). If you are pregnant and pull a high BG number, go for a walk or get more active to help bring down your BG level. You don't have to wait till your next appointment to talk to your Dr/nurse and get some answers/stress relief. Take care...

Stephanie

January 4, 2011 3:53 a.m.

As it is said, nowadays many women tend to hear the sound of their unborn baby's heartbeats in their pleasant pregnancy, even when doctors are not beside their sides. They would more like to hear that beautiful sound when they feel most comfortable at ease.

Julianna

November 22, 2010 10:18 a.m.

Your doctor must have an a high level of suspicion that you are diabetic, perhaps not just duiring pregnancy. Follow your diet closely. Eat all that you are supposed to eat. Check your blood sugars regularly. I'm not sure about the bedrest, you might ask about that. When you are told to come off of bedrest then start an exercise program for pregnant women. That will help your blood sugars to stay with in the limits you need. Let us know how the pregnancy is advancing please.

mary @ Mayo

November 10, 2010 11:40 a.m.

I am only 5 weeks and 3 days, but my gyn is screening me for gestational diabetes. My GCT result was 143, and she is advicing diet and bedrest for now. I am so scared. please advice!

Meg

November 3, 2010 4:19 a.m.

I was suffering from diabetes from last 10 years, from past 4 weeks i am very much benefited after started consuming Herbal Destination's GlucoSuprs Hrx regularly. I highly recommend this dietary supplement which is very effective.

Chaya

June 24, 2010 8:53 a.m.

I have been diagnosed with gestational diabetes. I really do not understand because I do not have a family history of diabetes. I have not gained excessive amount of weight (I'm 27 weeks and only gained 12lbs so far) and the numbers they said I was off by seems confusing. They said I failed the 2nd hr and the 3rd hr. My levels ont he 2nd hr was 136 and the third was 109, but I did research and according to my numbers, they are normal.

Rose

June 22, 2010 5:29 p.m.

I had gestational diabetes during all 5 of my pregnancies, and am now 43 years old. My youngest child is almost 9 years old. Treatment for me consisted of diet, exercise and daily monitoring. All of my babies were between 7 and 8lbs. I have read that women who have GD have a higher probablility of developing diabetes later in life. I have always been considered a healthy weight at 155-122lbs and 5'3, have low BP (90s/60s), and low cholesterol. I have continued to exercise regularly and watch my diet. How often should I have my BG checked? I sometimes have symptoms of diabetes, such as frequent urination and feeling hungry/thirsty. I also have poor circulation in my hands and feet, which is something I have had for years, but seems to be be slowly becoming worse. I have been checked twice since my last child's birth, both were fasting BG and both were between 100-110. Do I need to have the 3 hour test?

Maria

May 12, 2010 6:21 p.m.

My D-I-L is 26 weeks pregnant and has ruptured membranes (ie her water broke 4 weeks ago). She has been hospitalized but has since been released as no contractions have ensued. The baby is growing (currently just shy of 2 lbs) but yesterday our D-I-L was diagnosed with Gestational diabetes. I suspect that that is partly because she is on complete bedrest and doesn't get up (exercise is crucial for keeping GD at bay). Any comments from anyone who has dealt with a similar situation would be welcome and &quot;how it all turned out&quot;. Thanks!

Janet

April 23, 2010 9:49 a.m.

I was diagnosed at 26 weeks. This is very upsetting. I've been watching my weight (only 19lbs so far @ 28 weeks). I have a family hx of diabetes, which is infuriating. I've been put on Glyburide 5mg and have been on it for two days. My fasting numbers are 121 and 115 so far. My after breakfast #'s are sky high (207 &amp; 244). I've been cutting out sugar left and right and I thought I've been eating all the right things (according to all the diabetes books i've been looking at) but my #'s are still so out of control! I've read that this medication isn't even approved for use during pregnancy according to the manufacture! I had to go and buy my own meter and strips to monitor because meds were sent to me and no instructions besides when to take them! My next OB appt isn't for 4 days and I'm just lost and terrified for my baby! UGH! I'm sorry. I just needed to vent because this situation is so stressful that I just want to cry every moment!

Tanishia

April 16, 2010 2:13 p.m.

April 16, 2010 3:04 p.m.
My boyfriend is a type 2 diabetic. He was diagnosed about 8 months ago. His abdomen is exteded and recently his legs have swollan quite a bit to the point he has hard time walking they are so heavy. He was very thin wheight was 145, gained 30 pounds. What is causing this as I am concerned. He is a vet but does not have health insurans. He is 43 years old and does not smoke.

Patricia

March 31, 2010 10:39 a.m.

I am currently 34 weeks pregnant. I was diagnosed with gestational diabetes only 3 weeks ago. I started a lower sugar diet two weeks before that when my first glucose test came back high. I do have a history of Type 2 diabetes in my family (both paternal grandparents), but I have never been obese. I currently weigh 175 and my prepregnancy weight was 155, with a height of 5'6". I am 23.
I have been very frustrated. I can eat the same things every day and have hugely different numbers, though they are typically within range. I feel that the solutions being given to me are only a temporary fix and not all that effecive either. I do want to have more children, but I don't want to repeat gestational or regular diabetes. Any tips or recommendations are greatly appreciated.

Marissa

March 22, 2010 1:51 p.m.

Sometimes the hardest thing about the diet for gestational diabetes is that it is a diet. There is plenty of food that you can eat but it can seem like your are hungry all of the time because you're not getting what you want to eat. If that is the case, work with the nutritionist of dietician to find a way for you to that you are not only full, but satisfied also.

Mary@Mayo

March 4, 2010 6:51 p.m.

I was diagnosed with gestational diabetes at week 28 by failing my glucose test so badly I didn't need to take the follow up three hour test. I was in complete shock (and a bit angry) as I have none of the risk factors. I'm very fit, 5'3'', 113 lbs (prepregnancy) and have no family history of diabetes of any type. For the most part, I have been able to manage my blood sugar numbers with a strict diet and walking, but I do get unpredictable spikes here and there. Eating a very low carb diet, fitting in multiple walks a day, and taking my blood sugar four times a day has been a stressful process - epecially while trying to do my full time job and get ready for my first child. But it does get easier over time. I've only gained 15 pounds and am at week 36, but my doctor doesn't seem to be too concerned. I think this due to the restricted diet that I'm on (lots of meat, cheese, nuts, yogurt, eggs and raw veggies). This week I was finally put on glybruride to help stabalize my numbers and have been told that I'll need to be induced at week 39 if I don't go into labor earlier. While the last few months have been a challenge at times, I've still really enjoyed being pregnant and I've learned a ton about my body and my baby. We've both been monitored a lot since week 32 and so far we're both doing great! I can't wait for that piece of chocolate cake coming my way in three weeks!

Anonymous

February 26, 2010 6:17 p.m.

Many if not most of the medical profession are not aware that gestational diabetes may be a precursor to Type 1 diabetes, not just Type 2 diabetes. The stress of pregnancy is &quot;the straw that broke the camel's back&quot; for many women who develop Type 1 diabetes during pregnancy (autoimmune gestational diabetes). Antibody testing (GADA, ICA, IA-2) can be used to distinguish autoimmune gestational diabetes, and women with autoimmune gestational diabetes should begin intensive insulin therapy immediately. In Europe, the literature on gestational diabetes mentions autoimmune gestational diabetes, but in North America the layperson literature doesn't mention it. However, the existence of autoimmune gestational diabetes is widely reported in North American scientific literature (for example, a July 2007 &quot;Diabetes Care&quot; article and also an April 2003 &quot;Diabetes Care&quot; article on GDM). The July 2007 issue of &quot;Diabetes Care&quot; indicated that autoimmune gestational diabetes (new onset Type 1 diabetes) accounts for about 10% of all Caucasian women diagnosed with gestational diabetes (Diabetes Care July 2007 vol. 30 no. Supplement 2 S105-S111 ).

Melitta

February 19, 2010 3:55 p.m.

I’m 13 weeks and I have gestational diabetes, the first reaction that I had was between panic and worry I’m barely starting with my pregnancy, and I do not want to use insulin my pregnancy was categorized as high risk I was send to the nutrition and the diet is very strict but is working, I’m under control only with the nutrition I have been on the diet for 3 days but I can see the difference my energy is back , headaches are gone , and I’m able to sleep and the best part is that my numbers are between the range.

Maria

October 15, 2009 10:54 a.m.

This is a timely issue in women's health. The incidence or gestational diabetes has increased significantly in the past decade due to an increase in obesity as well as women being pregnant later in life as compared to previous years.
Most of the time, after the baby is born, the diabetes disappears but the only way to know for sure is to repeat the glucose test.
Interestingly, many women who have had gestational diabetes later develop Type 2 Diabetes (adult onset). Women with Type 2 Diabetes are more likely to have features of the &quot;metabolic syndrome&quot; such as obesity, high cholesterol, and high blood pressure as well as the diabetes. As well, women with a history of gestational diabetes are still more likely than those without to have indices of the &quot;metabolic syndrome&quot; even when they do not have Type 2 Diabetes.
If you have (or have had) gestational diabetes, be sure to eat healthfully, maintain an active lifestyle and consult your midwife, nurse practitioner or physician for further evaluation and suggestions. While a temporary condition in pregnancy, gestational diabetes can have life-long implications.

Kathleen

October 11, 2009 12:03 p.m.

Hi,
You mention that certain ethnic groups are more susceptible to gestational diabetes. I'm an Indian (South Asian), can you please tell me if I belong to a more susceptible group or not please? Thanks!
Subha
http://howdoyougetpregnant.org/

Subha

October 7, 2009 8:19 p.m.

I had gestational diabetes with my last pregnancy. She is now 10 weeks old. I was very discouraged and thought my life was goin to end! I was constantly on the internet and all there were-horror stories. If you do this, this would happen, if you do that that would happen. I did follow the diet that was given by the dietician (cheated a few times). I started it at 28 weeks. I kept my numbers in range, however I did have afew out of range, ecspecially my fasting numbers. That's when you dont get on the internet! I was scared to death i was going to put on insulin. I never was put on insulin. My doctor was impressed with my numbers. I never gaind any weight during my entire pregnancy, and i am 40 pounds lighter now then the day i found out i was pregnant! I ended up going into labor at 38 weeks. I had a healthy 7 lb. baby girl. Her suger readings were normal! I just wanted to let anyone know that is struggling with gestational diabetes that it not all a bad thing. It was hard to get used to the eating schedule but it all was well worth it.

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